Once the stuff of Victorian novels, maternal mortality is on the rise again in America. Amnesty International's calling it "scandalous." How is this an increasing problem in 2010? Perhaps it's because we're pushing the fertility envelope.

Over the past decade, the U.S. maternal mortality rate has nearly doubled, with about 500 women dying of pregnancy-related complications each year. That's a tiny percentage of the 4 million American women who give birth annually. But what's shocking is that among industrialized countries, the U.S. ranks an abysmal 41st on the World Health Organization's list of maternal death rates, behind South Korea and Bosnia-yet we spend more money on maternity care than any other nation.

In addition to the actual death, one third of pregnant women in America are thought to suffer from pregnancy-related complications. Indeed, it's become enough of an issue in the U.S. that Amnesty International, in a report titled "Deadly Delivery: The Maternal Health Care Crisis in the USA," has termed the maternal mortality rise a human rights concern. The physical causes of what is also called "obstetrical death" are, according to the WHO, haemorrhage, infection, high blood pressure, and obstructed labor. But the reasons behind the rising morbidity are less straightforward and range from too little care, to, ironically, too much. Some possible causes are the high rates of C-sections; the fact that more mothers are having babies older; rising obesity rates; gratuitous medical interventions that lead to complications; and, of course, the low standard of health care for many Americans. As Nan Strauss, an author of the Amnesty report put it to CNN, "The thing that really struck us was that these problems hit women of color, low-income, particularly hard...But every woman who is going through pregnancy in this country is at risk."

The disparity in care, at least, could potentially be addressed by reforms that (theoretically) guarantee pre-natal care to all pregnant women. In addition, regular consultations with doctors could hopefully help women reduce risky behaviors that, absent of medical counsel, can endanger a pregnancy. But this will, obviously, not happen overnight, and these numbers are steadily climbing. Education is a crucial factor here, and while volunteer opportunities vary from state to state (VolunteerMatch is a good starting point), many regions offer prenatal classes that, especially for young mothers, could be life-saving. Sound melodramatic? Yeah, well, these are some dramatic numbers.